As soon as Blair woke the following morning, he knew something was wrong. He lay in bed and tried to force himself to move, but his body stayed stubbornly still, his legs totally numb and his hands feeling tingly, as though heíd slept on them. Taking a deep breath that seemed to drain his energy and make him dizzy, he called out. "Jim."
There was no answer and Blair could hear the shower running now. Jim was in the bathroom, oblivious to his calls. He had no need to have his hearing dialed up.
"Jim." Blair shouted the name, panic making his voice quaver.
Jimís voice answered and Blair could see steam billow from the bathroom as his partner opened the door. "Iíll be out in a minute, Sandburg."
Terror seemed to close Blairís throat as he heard the bathroom door shut once more, leaving him alone, and he surged upward in the bed, his mind distantly relieved that his arms appeared to be working. Hoping that perhaps his condition was simply due to one of those weird nightmares where you think youíre paralyzed, but youíre not, he pushed the bedclothes back and stood upÖ
ÖOnly to fall flat on his face, one panicked hand reaching out for the chair, sending it crashing to the floor beside him. From his position on the floor, Blair could see a skewed view of Jim as the door opened once more and he stepped out with a towel wrapped around his waist. He looked toward Blairís room and whatever it appeared heíd been about to say seemed to die on his lips.
Hurrying forward, the detective knelt at Blairís side and lifted one of his arms, checking the pulse at his wrist. "Blair? What the hell happened?"
Blair tried to speak, but could only manage a pathetic keening wail that frightened him as much as it appeared to panic Jim. Tears spilled from his eyes and coursed down his cheeks as his body shook.
Jim squeezed his shoulder and began to stand, only to kneel again when Blair snaked out a hand and clutched at his arm in panic. "I need to get the phone, Chief. All right? Iím going to call an ambulance."
Blair nodded and watched Jim leave the room, trying desperately to rein in his spiraling fear. His chest felt tight and breathing had become difficult, though Blair was not sure whether that symptom was due to a panic attack or something more sinister.
Jim was back almost before he had the time to blink, crouching again at Blairís side. He cradled the phone against his ear with one shoulder while reaching to squeeze Blairís hand.
"They want to know what happened, Chief."
Blair shook his head. "I donít know," he answered. "Jim, I canít feel my legs. I tried to get up, but I canít." He took a gulping breath of air. "Itís hard to breathe."
Jim nodded and stroked a hand gently up and down Blairís arm. Blair forced himself to concentrate solely on Jimís touch, allowing it to keep him from sliding into a full-blown anxiety attack.
Not realizing he'd drifted off, he opened his eyes as something cold touched his chest and looked up into the dark brown eyes of a Hispanic-looking man in a paramedicís uniform.
"Can you hear me, Mr. Sandburg?" The man rubbed his knuckles hard along Blairís breastbone and he winced and shifted under the touch.
"I can hear you," he replied, then craned his neck to search for his partner. "Whereís Jim?"
Jim immediately appeared at his side. "Right here, Chief. I just needed to show the paramedics what meds youíre on."
Blair nodded and gripped Jimís hand. "Itís hard to breathe."
Jim looked quickly at the paramedic, then smiled down at Blair. "Theyíre going to start an IV and give you some oxygen," he assured his partner. "Youíll be at the hospital in no time."
Blair looked alarmed. "Youíre coming with me, arenít you?"
"All the way." He gestured at the towel around his waist. "Just let me go throw some clothes on."
Blair jumped as he felt a sharp pain in the back of his hand.
"Sorry about that," the paramedic said. "Should have warned you, huh?"
"At least I felt it," Blair said with a hint of a smile, his fear receding slightly at the realization. He swallowed as an oxygen mask was placed over his mouth and nose and then a cervical collar was snapped into place around his neck.
"Just taking every precaution, Mr. Sandburg," the paramedic assured him. "Detective Ellison tells me you had a fall yesterday."
Blair attempted to nod over the constriction of the collar. "Is that why I canít feel my legs? I feel a little light-headed too."
"Your blood pressureís a bit low." The paramedic squeezed his shoulder and smiled, then nodded to his partner who moved to place a backboard next to Blair. "Weíre going to log roll you onto a backboard now and then get you onto a gurney. Just let us do all the work."
Blair nodded again, his breath fogging the facemask as his chest seemed to become heavier and he found it becoming more difficult to pull in air. He tried to ignore the nausea that cramped his stomach as he was rolled sideways, then back.
He could feel the unyielding surface of the backboard beneath him and he stiffened as straps were tightened over his chest, forcing the constriction to become worse. His heartbeat seemed to swell in his ears, deafening him and his vision grayed out.
Fear tightened Jim's chest as he saw Blair's eyes roll up into his head and he became limp and unresponsive to the paramedic's questions. Another sternal rub elicited no response, and the paramedics exchanged concerned looks before bundling up their equipment and pushing the gurney toward the door.
"Are you riding in with us, sir?" the dark-haired paramedic whose badge identified him as Davide, asked.
Jim nodded as he pulled the front door shut. Stepping closer to the gurney, he took the proffered IV bag from Davide's hands and followed the small group into the elevator. He gave as much of Blair's medical history as he could remember on the ride down to the lobby.
Once in the ambulance, the IV was placed on a hook in the vehicle's roof and Jim sat forward on the seat, only vaguely registering the paramedic relaying Blair's symptoms and vital signs over the radio. He tried to focus his senses on Blair's heart and lungs but they refused to cooperate, his fear invading them and throwing him off-course.
He looked at Blair, frowning at the ashen pallor of his partner's face and his shallow breaths. Tentatively, he took Blair's cold hand in his and squeezed it gently. "Come on, Chief. Open those eyes, huh?"
A slight bump shook the gurney and prodded Blair toward consciousness. Struggling to open his heavy eyelids, he gazed in confusion at the slightly familiar surroundings and suddenly realized he was being rolled through the doors of the hospital entrance. He struggled to sit up, forgetting about the restraints that bound him to the backboard. Looking around in panic, Blair flinched at the firm hand on his shoulder that pressed him back onto the gurney.
"Easy, Chief. Take it easy."
Blair relaxed at the sound of Jimís voice and concentrated on trying to breathe normally as he felt himself lifted and placed on another bed. A stern face swam into view and a harsh light shone in his eyes, making him wince.
He felt hands upon him, the straps gone and his clothes stripped away and then a rush of chill air that caused him to shiver violently.
"Can you tell us what happened, Blair?"
The voice sounded familiar and Blair tried to place it, then gave up in favor of answering the question. "I fell."
"You fell yesterday, didnít you?" another voice asked.
"And today." He felt vague, his thought processes slow and unwieldy. It seemed as if an iron weight had settled upon his chest and he began to panic again. "Jim!"
Jimís face appeared from over his head, his hand reaching down to clasp one of Blairís. He tried to close his fist around Jimís, but he couldnít seem to get the muscles to work. Then suddenly the weight on his chest increased and he could hear his heart pounding, sounding louder and louder in his ears as his vision grayed out again and then turned black.
Jim stared in shock as Blairís body became suddenly limp and his eyes rolled up into his head. He looked at the doctor, then shook his partnerís shoulder frantically. "Blair? Answer me. Blair?"
His hands were pushed away as the doctor pressed a stethoscope to Blairís bare chest.
"Respiratory arrest," the doctor announced and Jim was pushed aside as a crowd of medical personnel descended upon the unresponsive body of his partner. Shocked into submission by the frightening turn of events, Jim did not argue as a nurse steered him out of the room.
"Wait in the waiting room," she ordered. "Someone will come talk to you as soon as they can."
Jim nodded mutely and turned toward the banks of chairs. Then he turned around and headed for the payphone by the entrance doors. Having made his call, he walked resolutely back to the trauma room and slipped inside, his arrival unnoticed by the bustling doctors and nurses, his attention fixed solely on the lifeless body of his partner.
He watched silently as Blair was intubated once more. Blinking back the memories of the last two times he had seen Blair subjected to this treatment, he wiped angrily at the sole tear that escaped down his cheek.
He allowed the jumble of medical terminology to wash over him Ė CBC, Chem7, urinalysis - and concentrated on willing Blair to wake up, not aware that heíd taken several steps forward until he stood once more at his partnerís side. Reaching out to clutch Blairís lifeless hand, he glared at the nurse who rushed to his side, attempting to move him away.
"Did you come in with him?"
He pulled away from the nurseís grip and turned to face the man standing over Blair. He was young, with long dark hair tied back into a shoulder-length ponytail. His brown eyes regarded the detective appraisingly.
"Yes," Jim answered shakily. "Heís my partner."
"How long has he been sick?"
"A week or so. He drowned two weeks ago."
The doctor looked up sharply at the comment and then waved the nurse away. "Go get me the case notes, would you?"
"Dr. Mason treated him then," Jim added. "Heís been taking antibiotics and steroids for a chest infection. We just got back from Mexico the day before yesterday and he had a fall down some steps at the university yesterday."
He reached forward and stroked along the stitches on Blairís temple. He felt a memory nudge at his dazed mind and he looked at the woman pushing air into Blairís lungs with an ambu-bag connected to the endotracheal tube, before he spoke again. "He said his mouth was numb and heís been a little shaky."
A nurse finished hooking Blair up to the various monitors surrounding him, then called out the readings as they flashed onto the screen.
"BPís 80 over 50, tempís 101.4, pulse 50."
The doctor nodded. "Heís hypotensive, bradycardic. Temperatureís not real high." He pulled his stethoscope from around his neck and bent to listen again to Blairís chest. "Heís got some rales bilaterally." The doctor looked up at the nurse bagging Blair. "Cease bagging for a second."
Jim stepped forward, dialing up his own hearing in a desperate attempt to hear air rushing into Blair's stilled lungs. The nurse obeyed and all noise in the room, save for the beeping of the heart monitor, ceased; all attention focused on the unconscious man. Jim knew his hopes were futile before the doctor spoke.
"No spontaneous respiratory effort."
He motioned for the nurse to continue breathing for Blair, then reached for a percussion hammer and pulled the sheet from Blairís naked body. He lifted first one knee and then the other, checking the reflexes.
"Set up for an LP," the doctor finally said. "Probably worth doing an NSV too, though I think the symptoms are fairly conclusive." He looked again at Jim. "Are you squeamish?"
Jim shook his head and reached again for Blairís hand. "Iím a detective with Major Crime."
"Iím Doctor Steve Carter."
"Jim Ellison. Blairís my partner and roommate."
"Okay. Iím going to do a spinal tap on your friend here. I suspect he may have Guillian-Barre Syndrome."
"Itís also known as Landryís ascending paralysis. Iíll explain it to you as I work. The quicker we can get the results to the lab, the quicker we know what weíre dealing with. Blair may regain consciousness at any time and heís going to be very frightened that he canít breathe for himself. Do you think you can keep him calm until Iím done?"
Jim nodded without hesitation.
"All right. Letís do this. Hook him up to the vent and then get him on his side. Detective, pull up that chair and sit facing Blair."
Jim raised his eyes from Blairís white face and looked over at the doctor sitting opposite him, the faint tinkle of metal on metal the only indication of the procedure taking place. The mask he wore mostly concealed the doctorís features, but his brown eyes were serious as he spoke.
"Guillian-Barre Syndrome is a disorder in which the bodyís immune system attacks parts of the nervous system. Symptoms include varying degrees of weakness or tingling sensations in the legs. In many instances, the weakness and abnormal sensations spread to the arms and upper body. The symptoms can increase in intensity until the muscles canít be used at all and the patient is almost totally paralyzed."
"Weíve put Blair on a ventilator to assist with breathing and weíll need to watch him closely for problems such as an abnormal heart beat, infections, blood clots, and high or low blood pressure. His heartbeat is a little slow and his blood pressure is low. I already know from his chart that he was being treated for a severe respiratory infection secondary to his drowning. That could complicate his recovery."
"Could he die?" Jim whispered, unsure if he wanted to know the answer. He stroked the back of Blairís hand with his fingers, the touch soothing him.
"Most patients recover from even the most severe cases of Guillian-Barre syndrome, although they may suffer some continuing minor problems. Less than 5% of Guillian-Barre sufferers die, Detective. Blair was lucky. He was already in the hospital before his chest muscles became paralyzed so he was artificially ventilated immediately. He wasnít without oxygen long enough to suffer any brain damage. Tell me about his drowning."
Jim took a deep breath. "He was attacked by a criminal I was chasing. She took him captive at Rainier University. Heís an anthropologist there."
The doctor raised his eyebrows at this information but said nothing, so Jim continued. "We think she forced him out to the fountain at gun-point and knocked him unconscious beforeÖ beforeÖ"
Dr. Carter nodded. "I read about it in the newspaper and it did the rounds here when he was brought in. He was incredibly lucky to survive after being in full arrest for so long."
"Heís strong," Jim whispered.
"Heís my partner." Jim wondered if the doctor had any idea what that meant. "What causes this syndrome?"
"Guillian-Barre usually occurs a few days or weeks after the patient has had a respiratory or gastrointestinal infection. It can develop over the course of hours or days, or it may take up to 3 to 4 weeks. Most people reach the stage of greatest weakness within the first 2 weeks after the symptoms appear, and by the third week of the illness, 90 percent of all patients are at their weakest. Thereís not a lot known about what causes it yet."
The sensory onslaught of the bustling activity around them was distracting. Nurses came and went. The smell of antiseptic stung Jim's nose and eyes. Someone dropped a metal tray and he fought not to cringe at the deafening crash. Further up the hallway, a woman moaned in pain. Jim tried to rein in his senses and concentrate on the doctor's words.
"Usually the cells of the immune system attack only foreign material and invading organisms. In Guillian-Barre syndrome, the immune system starts to destroy the myelin sheath that surrounds the nerve cells. The muscles begin to lose their ability to respond to the brainís commands. The brain also receives fewer sensory signals from the rest of the body, resulting in an inability to feel textures, heat, pain, and other sensations."
Jim looked down again as his hearing picked up Blairís accelerating heartbeat even before the monitors sounded their alarm.
"Blair? Itís okay, Chief. Iím here."
Blairís eyes were open, blue irises almost black as he stared up at his partner, stark fear evident on his pale face.
"Can you keep him calm, Detective? Weíre almost done here."
Jim nodded, but continued to look at Blair, willing the young man to trust him. "I know youíre scared, buddy, but youíre going to be fine. The ventilator will breathe for you until you get stronger. Youíll be fine."
Blairís eyes closed momentarily and a fat tear welled up from under one lid, dripping slowly down his cheek. Jim wiped it away with a gentle thumb and went back to stroking soft circles of comfort on Blairís hand. Then he tried to will away the awful thought that Blair might not be able to feel his comforting touch. He was relieved to hear his partnerís heartbeat begin to steady.
"What happens now?"
The doctor handed three small vials of clear liquid to the nurse assisting him. "Weíll take him up to ICU and wait on the test results. If theyíre positive, the doctors up there may start him on blood washes and immunoglobulin injections. Theyíve been known to lessen the severity of the disease and shorten its duration somewhat. In the meantime, heíll be sedated and treated supportively."
"When will you know ifÖ when he can breathe again by himself?"
The doctor paused at the hand basin to wash his hands, then moved back to supervise Blairís transfer upstairs. "Theyíll lighten the sedation now and then and challenge his spontaneous breathing, plus keep a close eye on his reflexes to see if the paralysis is subsiding."
Both men followed the gurney and its small crew out of the trauma room. Up ahead, Jim saw Simon jump up from a chair in the waiting room and stride toward him.
"Iíve got other patients to attend to, Detective." Dr. Carter held out his hand. "Your partner will be in good hands. Given time and some intensive therapy, I think heíll pull through. Keep in mind though, that youíre looking at a couple of months before Blair is back on his feet again. Be patient. Give them an hour or so to settle him, then theyíll let you see him."
Jim nodded and shook the doctorís hand. "Thanks." He watched the doctor disappear into another trauma room then turned toward Simon.
"Jim?" The big police captain looked worriedly after the disappearing gurney and then at the detective. "Whatís wrong with him?"
Sighing deeply, Jim dropped heavily into a chair, scrubbing a hand wearily over his face. "He stopped breathing, Simon. Heís paralyzed."
"What?" Simon looked as stunned as Jim felt. "How? Why?"
"He has some kind of syndrome. God, I canít even remember the name of it, let alone pronounce it. French-sounding. Anyway, itís some sort of disease caused by a viral infection. His mouth was numb. It causes a kind of paralysis."
Simon sank into the seat next to him and stared ahead silently for a long moment before looking at Jim. "Was this because he came to Mexico, after us?"
Jim shrugged. "I donít know, but it canít have helped. Damn him! Why couldn't he have stayed in the hospital where he was safe? All that humidity has got to breed God knows what germs. Why the hell did he have to come after us?"
"I think you already know the answer to that."
"Yeah, you're right. Stubborn littleÖ He'd just drowned, for Christ sake. What did Conner think she was doing, letting him get on a plane? I could have handled it without him. "
"He's your partner." Simon patted his shoulder. "Plenty of time for recriminations and what-ifs later. What are they going to do?"
"Some sort of blood wash, immunoglobulin injections. The doctor thinks heíll get better eventually but heís going to need physical therapy when the paralysis wears off."
"Itís not permanent? Thank God."
"His condition is critical. It could still go either way because of his chest infection and weakened condition." Jim buried his face in his hands. "If Iíd just listened to him that first night when he tried to tell me about that bitch." He looked at the captain. "I pushed him away, Simon. Kicked him out."
"Don't do this to yourself!" Simon ordered. Looking around quickly, he put a hand on Jimís shoulder and lowered his voice. "You did not drown him. You did everything you could. You brought him back from the dead. You caught Alex Barnes. She did this, not you."
Jim stared at him tiredly. "I pushed him away and left him unprotected." He stood up and motioned toward the elevator. "Iím going to wait upstairs in the ICU waiting room until they let me in."
"Iíll come with you." Simon stood. "Iíll give you a ride home after you've looked in on him."
Jim shook his head. "Iím not going anywhere. Iím not going to leave him to face this on his own."
"Do you think they'll let you stay with him?"
"They'll have to." Jim squared his jaw. "Iím not leaving him here alone."
Simon sighed and held out his hand. "Give me your keys." At the detectiveís questioning look, he smiled. "Iíll go to your place. Get your shaving gear, a change of clothes. Iíll drop them off here tomorrow on my way to work."
"Thank you, sir."
Simon reached up and gently squeezed Jimís shoulder. "You keep me apprised of his condition. Understand?"
Jim nodded and headed for the elevator.
To Chapter Four